Objective To investigate the effects of sustained-release basic fibroblast growth factor (bFGF) on healing of bile duct defect. Methods A model of bile duct wall defect (2 cm in length and 1/3-2/3 of the bile duct circumference in width) was made in 24 pigs (male or female, weighing 15-30 kg), and then defect was repaired with sustained-release bFGF collagen membrane (2.0 cm × 1.0 cm × 0.5 cm in size) in the experimental group (n=12) or with collagen membrane (2.0 cm × 1.0 cm × 0.5 cm in size) alone in the blank control group (n=12). Another 4 healthy pigs were used to obtain normal bile duct as normal control group. The survival condition of pigs was observed after operation; at 1, 2, and 3 months after operation, the blood sampling was collected to test the changes of liver function, and the bile duct specimens were harvested to count the microvessel density (MVD) and submucosal gland by HE staining and immunohistochemistry staining; and at 3 months after operation, cholangiography examination was done. Results All the animals survived to completion of the experiment. Intra-abdominal adhesion was serious in the experimental and blank control groups at 1 week after operation, but the adhesion was markedly improved in the experimental group when compared with the blank control group with time passing. The liver function test showed that alkaline phosphatase in the experimental group was significantly lower than that in the blank control group at 2 and 3 months (P lt; 0.05), but no significant difference in aspartate aminortransferase, total bilirubin, and albumin was found among 3 groups (P gt; 0.05). The histology and immunohistochemistry staining observations showed that the regeneration rates of submucosal glands and epithelium in the experimental group were faster than those in the blank control group; defect was covered with the epithelium at 2 months, and the structure was similar to that of normal control group at 3 months; and the edema and inflammation infiltration were reduced when compared with the blank control group. The counts of MVD and submucosal gland were significantly higher than those in blank control group and normal control group at 1 month after operation (P lt; 0.05), and then decreased and remained at normal levels at 2 months after operation. There was a positive correlation between submucosal gland counting and MVD counting in 3 groups after operation (P lt; 0.01). The cholangiography examination showed no biliary dilatation or cholelithiasis after 3 months in experimental group and blank control group. Conclusion Sustained-release bFGF can promote healing of bile duct defect by accelerating the vascularization, gland regeneration, and epithelialization.
Objective To improve the vigilance and awareness of malignancy presenting as dermatosis and reduce misdiagnosis. Methods Two cases of gastric cancer presenting as dermatomyositis and erythroderma respectively in the last two years were retrospectively analyzed and the relevant literatures were reviewed. Results The two patients were admitted to hospital due to skin diseases， diagnosis of gastric cancer through endoscopy， and proved to be gastric cancer associated with dermatosis by pathological examination after surgical resection. Conclusions Paraneoplastic dermatoses can be seen as an early manifestation of the internal malignancy. The patients with paraneoplastic dermatoses should be excluded visceral tumors by the means of biomarkers， endoscopy， PET/CT， and so on.
Objective To explore predictive value of radiological indexes for hemorrhage in patients with portal hypertension. Methods The clinical data and radiological data of patients with portal hypertension accompanied with hepatitis B from June 2008 to June 2014 in the Nanjing Drum Tower Hospital were analyzed retrospectively. Patients with hepatocellular carcinoma, portal vein thrombosis, or portal hypertension due to other causes, such as autoimmune hepatitis, pancreatitis, or hematological diseases were excluded. Results Ninety-eight patients were studied and subsequently divided into a hemorrhage group (n=57) and a non-hemorrhage group (n=41). There were no statistical differences in the clinical indexes such as the age, prothrombin time, serum albumin, serum creatinine, serum sodium, white blood cell count, and blood platelet count (P>0.05). However, the differences were statistically significant in the serum total bilirubin, hemoglobin, and liver function with theP values of 0.023, 0.000, and 0.039, respectively. For the radiological indexes, the hemorrhage was correlated with the diameter of posterior gastric vein (P=0.028 3) or grading of esophageal varices (P=0.022 1). Logistic procedure was used to construct the model with stepwise selection and finally the diameter of inferior mesenteric vein, diameter of posterior gastric vein, grading of esophageal varices, and diameter of short gastric vein were enrolled into this model. These indexes were scored, the risk of bleeding increased with increasing the points. Then the model was validated with 26 patients with portal hypertension from July 2014 to December 2014, the area under the receiver operating characteristic curve was 0.884 9 by this radiological model. Conclusions A radiological scoring model is constructed including diameter of inferior mesenteric vein, grading of esophageal varices, diameter of posterior gastric vein, and diameter of short gastric vein, which might predict risk of hemorrhage in patients with portal hypertension. However, further protective study of large sample is needed to validate this model.